Primary repair of esophageal atresia: How long a gap?

C. G. Howell, J. B. Davis, R. A. Parrish

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Primary esophagoesophagostomy is the treatment of choice for repair of esophageal atresia, particularly the more common type C atresia. Debate continues, however, regarding repair of the type A, or long-gap esophageal atresia. Since the pioneering work of Livaditis, Howard and Myers, the frequency of primary repair of long-gap atresia has increased. Interposition grafting, however, remains as the treatment for gaps longer than 6 cm or with absence of a distal intrathoracic esophageal segment. We report a case of primary esophagoesophagostomy with proximal esophagomyotmy in a 1,900-g infant with an absent distal intrathoracic esophageal segment and an eight vertebral body gap. Utilizing daily bougienage of the proximal and eventually the distal segment, a 1-cm gap was present at 6 months of age. With intraoperative fluoroscopy, the distal intra-abdominal esophageal segment was manipulated thru the esophageal hiatus. Thru an extrapleural approach with a proximal esophagomyotomy, a delayed primary anastomosis was successfully performed. She is currently 3 years old and has a normal barium swallow without stricture or gastroesophageal reflux.

Original languageEnglish (US)
Pages (from-to)42-43
Number of pages2
JournalJournal of Pediatric Surgery
Issue number1
StatePublished - Jan 1 1987
Externally publishedYes


  • Esophageal atresia
  • esophageal myotomy
  • esophageal replacement

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery


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